Early diagnosis and treatment of Legionella pneumonia is essential. We examined the clinical features of 9 patients with Legionella pneumonia in our hospital and here we report the characteristics of community-acquired pneumonia in this rural area to facilitate diagnoses of Legionella pneumonia. All patients were male, had low CO2 levels, hyponatremia, and a high creatine phosphokinase levels. Eight patients had high aspartate transaminase and alanine transaminase levels, and 7 had a low estimated glomerular filtration rate. The source of infection was determined in 6 patients: hot springs (n = 4), a refrigerated vehicle (n = 1), and well water (n = 1). Six patients were diagnosed using the urinary Legionella antigen test, and 3 were diagnosed using loop-mediated isothermal amplification (LAMP) of sputum samples. In such patients, it is therefore important to examine urine antigens and carry out polymerase chain reaction analysis (or LAMP) of sputum.

BACKGROUND/AIMS: L-carnitine not only alleviates hyperammonemia and reduces muscle cramps in patients with liver cirrhosis, but also improves anemia in patients with chronic hepatitis and renal dysfunction. This study prospectively evaluated the preventative efficacy of L-carnitine supplementation against hemolytic anemia during antiviral treatment using ribavirin in patients with hepatitis C virus (HCV)-related chronic liver disease. METHODS: A total of 41 patients with chronic hepatitis were consecutively enrolled in this study. Group A (n=22) received sofosbuvir plus ribavirin for 3 months, whereas group B (n=19) was treated with sofosbuvir, ribavirin, and L-carnitine. Hemoglobin concentration changes, the effects of antiviral treatment, and the health status of patients were analyzed using short form-8 questionnaires. RESULTS: A significantly smaller decrease in hemoglobin concentration was observed in group B compared to group A at every time point. Moreover, the prescribed dose intensity of ribavirin in group B was higher than that of group A, resulting in a higher ratio of sustained virological response (SVR) 24 in group B compared with group A. The physical function of patients in group B was also significantly improved compared to group A at the end of antiviral treatment. CONCLUSIONS: L-carnitine supplementation alleviates ribavirin-induced hemolytic anemia in patients with HCV and helps relieve the physical burden of treatment with ribavirin-containing regimens. These advantages significantly increase the likelihood of achieving SVR.
Anemia ; Anemia, Hemolytic ; Carnitine ; Drug Therapy ; Hepacivirus ; Hepatitis C ; Hepatitis C, Chronic ; Hepatitis ; Hepatitis, Chronic ; Humans ; Hyperammonemia ; Liver Cirrhosis ; Liver Diseases ; Muscle Cramp ; Prospective Studies ; Ribavirin ; Sofosbuvir